Why the study?
Catastrophic antiphospholipid syndrome and lupus myocarditis are two rare life-threatening conditions.
This case highlights the successful use of early mechanical circulatory support and targeted immunosuppressive therapy for managing profound cardiogenic shock caused by catastrophic antiphospholipid syndrome and lupus myocarditis.
Hypothesis-generating for early mechanical support plus immunosuppression in catastrophic APS myocarditis; prospective studies required before practice change.
Background: Catastrophic antiphospholipid syndrome and lupus myocarditis are two rare life-threatening conditions. Case summary: We present a case of a 47-year-old woman admitted in profound cardiogenic shock due to catastrophic antiphospholipid syndrome and lupus myocarditis requiring advanced heart failure therapies, including early mechanical circulatory support. She improved with steroids, immunoglobulins, mycophenolate, and eculizumab. Discussion: This case highlights the importance of early identification of cardiogenic shock secondary to catastrophic antiphospholipid syndrome and lupus myocarditis, the arrhythmogenic complications of myocarditis, and the subsequent management of the disease progression with mechanical and medical support.
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Lai et al. (2022) studied this question.
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